Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,163.60 / $5,132.00 / $22,024.00	Facility		$1,163.60	$5,132.00	$22,024.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $582.66 / $806.05 / $1,748.65	Professional		$582.66	$806.05	$1,748.65
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $303.58 / $303.58 / $303.58	Professional		$303.58	$303.58	$303.58
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $6,526.97 / $19,913.50 / $38,781.51	Facility		$6,526.97	$19,913.50	$38,781.51
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $878.88 / $1,477.17 / $5,551.80	Professional		$878.88	$1,477.17	$5,551.80
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,005.16 / $1,223.70 / $8,315.84	Facility		$1,005.16	$1,223.70	$8,315.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $648.76 / $1,134.55 / $1,929.08	Professional		$648.76	$1,134.55	$1,929.08
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $642.92 / $1,314.64 / $7,292.72	Facility		$642.92	$1,314.64	$7,292.72
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $599.82 / $1,291.22 / $6,279.70	Professional		$599.82	$1,291.22	$6,279.70
Molina Facility/Professional Professional Modifier Low / Median / High Price $78.68 / $380.39 / $1,274.40	Professional		$78.68	$380.39	$1,274.40
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $868.77 / $1,183.89 / $1,277.69	Facility		$868.77	$1,183.89	$1,277.69
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $842.58 / $871.50 / $6,526.97	Facility		$842.58	$871.50	$6,526.97
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $969.03 / $1,386.39 / $1,729.84	Professional		$969.03	$1,386.39	$1,729.84
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $13,146.66 / $20,262.22 / $38,781.51	Facility		$13,146.66	$20,262.22	$38,781.51
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $859.32 / $1,240.46 / $1,659.68	Professional		$859.32	$1,240.46	$1,659.68
United Facility/Professional Facility Modifier Low / Median / High Price $2,155.00 / $3,129.00 / $11,941.00	Facility		$2,155.00	$3,129.00	$11,941.00
United Facility/Professional Professional Modifier Low / Median / High Price $742.70 / $986.70 / $1,791.69	Professional		$742.70	$986.70	$1,791.69
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $531.42 / $531.42 / $693.81	Professional		$531.42	$531.42	$693.81